BACKGROUND: Vibrio(V.) vulnificus is a halophilic, gram-negative bacillus that causes a fatal sepsis in patients with underlying chronic disease such as liver cirrhosis and alcoholic abuse. Because V. vulnificus infection has a fulminant course and high mortality rate, early recognition and rapid diagnosis with prompt therapy are necessary to improve survival rate. OBJECTIVE: The purpose of this study was to develop a new selective medium for rapid identification of V. vulnificus through color change of medium according to pH from patients suspected of having V. vulnificus sepsis. METHODS: Rapid isolation and identification of V. vulnificus can be possible by modifying the component of PNC(5% peptone, 1% NaCl, and 0.08% cellobiose [pH 8.0]) broth medium. From this PNC broth, a basal broth(5% peptone+1% NaCl+cellobiose) was prepared and used to evaluate additional medium supplements(cellobiose concentration [0.08, 0.2, 0.1%], pH [6.8, 7.5, 8.0] and pH indicator dye [bromthymol blue, thymol blue, phenol red, bromcresol purple, crystal violet, cresol red, and neutral red]). To examine the rapid identification and selectivity of this basal medium according to various conditions, V. vulnificus was tested by using saline and normal human blood containing these bacteria(1, 000 bacteria/ml), respectively at 37degrees C. A positive reaction(V. vulnificus growth) appeared as color change. The selectivity and identification capacity of this new broth was tested by using other 6 Vibrio species and 14 strains of other bacteria. RESULTS: Color change appeared only in the medium including bromthymol blue and thymol blue as a pH indicator dye. It was called the basal medium containing blue dyes as PNCB(peptone, NaCl, cellobiose and blue dye) medium. It took an average time of 4.8hr for becoming aware of yellow color change in PNCB broth after cultivating with saline mixed with V. vulnificus and 6hr in PNCB broth after cultivating with blood mixed with V. vulnificus. One Vibrio species and another 3 bacteria produced color change. So we confirmed that the final composition and pH of PNCB broth medium was 5% peptone, 1% NaCl, 0.2% cellobiose, 0.0004% bromthymol blue and 0.0004% thymol blue [pH 7.5] CONCLUSIONS: PNCB broth could be used as a selective and differential medium for rapid isolation and identification of V. vulnificus in patients with V. vulnificus sepsis.
Alcoholics ; Bacillus ; Bacteria ; Bromcresol Purple ; Bromthymol Blue ; Cellobiose ; Chronic Disease ; Coloring Agents ; Diagnosis ; Gentian Violet ; Humans ; Hydrogen-Ion Concentration ; Liver Cirrhosis ; Mortality ; Peptones ; Phenolsulfonphthalein ; Sepsis* ; Survival Rate ; Thymol ; Vibrio vulnificus* ; Vibrio*

PURPOSE: This study aimed to investigate the sexual attitudes and perception of sexual relationships and erectile dysfunction treatment among the wives of the long-term users of sildenafil (Viagra(R)). MATERIALS AND METHODS: The study was conducted as a market survey with using random face-to-face interviews and a structured questionnaire on a population of 31 wives (mean age; 49.8 years) of long-term sildenafil users who had first taken sildenafil 5 years or more previously and they continued its use in the previous 6 months. RESULTS: All the wives said 'It is desirable to have sex even though I am getting old, if I am healthy' and 84% had sex not for their satisfaction but for husband's satisfaction. Forty five percent perceived that having sex 1~2 times a week was ideal and 35% said having sex once per two weeks was ideal, and this was not different from happened in their real lives. Ninety four percent and 90% perceived that erectile dysfunction and women's sexual dysfunction should be treated, respectively, and 35% took a form of hormonal replacement therapy. The most influencing factors of sildenafil use on the overall satisfaction of wives' sexual and marital life were the increased frequency and intensity of orgasm and they became more intimate with their husbands, followed by the disappearance of depressed or annoying moods (p<0.01). They also felt the improved rigidity of their husband's erection after initial sildenafil use was maintained after more than 5-year use. CONCLUSIONS: Wives of long-term sildenafil users had positive, but husband-oriented sexual attitudes. They had an intercourse-focused perception on their sexual relationship, and they ranked the increased frequency and intensity of their orgasms and becoming more intimate with husbands as the most influential factors for their sexual and marital life, and they also felt that their husbands' erection rigidity was maintained after more than 5-year use of sildenafil.
Erectile Dysfunction ; Female ; Humans ; Male ; Orgasm ; Piperazines ; Purines ; Sildenafil Citrate ; Spouses ; Sulfones

Aged ; Hemoptysis ; chemically induced ; Humans ; Male ; Middle Aged ; Piperazines ; adverse effects ; Purines ; Sildenafil Citrate ; Sulfones

Sildenafil is an effective oral medication for male erectile disorder. Due to potential vasodilating effects, silenafil is known to have side effects such as headache, flushing, dyspepsia, and nasal congestion. Recently, we experienced a case of acute unilateral vestibular weakness that occurred in a 39-year-old man after ingesting sildenafil. The symptom lasted for 2 weeks and then was resolved partially. To the best of our knowledge, this is the second case report of sildenafil induced vestubular weakness in the literature. Thus, we report a case of a rare side effect of sildenafil.
Adult ; Dizziness ; Dyspepsia ; Eating ; Estrogens, Conjugated (USP) ; Flushing ; Headache ; Humans ; Male ; Piperazines ; Purines ; Sulfones ; Sildenafil Citrate

OBJECTIVE: To evaluate erectile dysfunction in patients with spinal cord injury and the relationship between patient's subjective answers and the results of objective tests regarding erectile dysfunction. METHOD: Twenty-one male patients with erectile dysfunction after spinal cord injury were administered with nocturnal penile tumescense and rigidity testing (NPTR) using Rigiscan(R) over 2 consecutive nights. NPTR using Rigiscan(R) at second night was performed after oral administration of sildenafil 50 mg. Answer of the global efficacy question (GEQ) after oral administration of sildenafil 50 mg and the parameters of NPTR were compared. RESULTS: After oral administration of sildenafil 50 mg, number and duration of erectile episodes, and duration of rigidity greater than 60% on NPTR improved significantly (p< 0.05). Sixteen out of seventeen patients (94.1%) who showed improved nocturnal erection after oral administration of sildenafil 50 mg answered that they had an improved erectile function after sildenafil. All four patients (100%) who showed no improvement in nocturnal erection after sildenafil answered that their erectile function was not improved after oral administration of sildenafil 50 mg. CONCLUSION: We expect NPTR using Rigiscan(R) might be useful for the evaluation of erectile dysfunction in men with spinal cord injury.
Administration, Oral ; Erectile Dysfunction ; Humans ; Male ; Piperazines ; Purines ; Spinal Cord ; Spinal Cord Injuries ; Sulfones ; Sildenafil Citrate

Purpose: This study was done to assess the therapeutic effect of trazodone, an antidepressant agent in combination with sildenafil in patients with erectile dysfunction (ED) and decreased libido with normal serum testosterone level. Materials and Methods: From March 2005 to February 2006, 90 patients with ED complaining of decreased libido but whose serum testosterone level was within normal range were screened and enrolled in this study. The subjects were randomly treated by sildenafil only (group 1) and combination of sildenafil with trazodone (group 2). Patients received trazodone for at least 3 consecutive months, with daily doses starting at 50 mg. By intention-to-treat basis, the period of study was extended by 9 month. The intention-to-treat population included 39 sildenafil recipients and 35 sildenafil with trazodone recipients. The patients were asked to make up two questions, Q1: 'Did you experience improvement of erection after treatment?' and Q2: 'Did you experience improvement of libido after treatment?' and the change of International index of erectile function (IIEF) scores before and after the treatment were analyzed to assess the efficacy of treatment. Results: After 3 month treatment period, 70% of group 1 and group 2 answered 'yes' to Q1. Twenty seven percents of group 1 and 51% of group 2 answered 'yes' to Q2 and 20% of group 1 and 24% of group 2 answered 'yes' to both Q1 and Q2. In the intention-to-treat population, seventy-two percents of group 1 and 71% of group 2 answered 'yes' to Q1 and 28% of group 1 and 52% of group 2 answered 'yes' to Q2, 21% of group 1 and 26% of group 2 answered 'yes' to both Q1 and Q2. The change of IIEF scores before and after the treatment at 3 month and 9 month showed similar results. Both group 1 and group 2 showed significant improvement on scores of IIEF-5 and question 15 of IIEF after treatment (p<0.01). Meanwhile, only group 2 showed significant improvement on question 11 and 13 of IIEF after the treatment compared to group 1 (p<0.05). Two patients with high dose of trazodone complained of headache and drowsiness, but the symptoms disappeared by dose reduction. Conclusions: The combination therapy of trazodone with sildenafil increased libido and sexual satisfaction on patients with ED. Therefore, combination of trazodone with sildenafil might be considered in ED patients of decreased libido with normal serum testosterone level rather than sildenafil monotherapy.
Erectile Dysfunction ; Headache ; Humans ; Libido ; Male ; Piperazines ; Purines ; Reference Values ; Sleep Stages ; Sulfones ; Testosterone ; Trazodone ; Sildenafil Citrate

PURPOSE: Sildenafil citrate(Viagra(R)), a PDE-5 inhibitor in the corpus carvenosum to facilitate penile erection has improved impaired erectile responses in men and has been accepted as a primary treatment of erectile dysfunction. However, complications occurred by Viagra have increased due to its overuse and misuse. Therefore, we have performed a survey to compare physicians and general population in Busan, Korea to assess their understanding of Viagra. Methods and Materials: In 2007, printed surveys were mailed to randomly sampled candidates of 197 primary physicians and 696 individuals from general population, 327 medical students in Busan were surveyed by door-to-door visits. We assessed opinions associated with Viagra eliciting their understanding about its safety, direction, and complications. Data were analyzed using SPSS and were identified by crosstabulation analysis using Ki-square test. RESULTS: Of 1,265 eligible responses, several differences were found between the 3 groups. Compared to general population, the others were more likely to understand the efficacy, directions, and complications of Viagra. Physicians and medical students(43.1% and 39.0%) gave more preference than general population(26.1%) to using Viagra. There were differences in understanding of Viagra with changes of education level. However, it showed no significant differences about idea of illegal Viagra and combination usage with nitrates. Conclusion: The number of patients using Viagra is increasing but their understanding about Viagra is still poor. Moreover, general populations understand Viagra as 'assistant' for erection poorly. Even some medical students understand more than physicians. The ideas of complications would likely affect to negative thinking about usage for Viagra. Therefore more active and continuous educations for proper use of Viagra are suggested for medical efficacy and less complications.
Erectile Dysfunction ; Humans ; Korea ; Male ; Nitrates ; Penile Erection ; Piperazines ; Postal Service ; Purines ; Students, Medical ; Sulfones ; Thinking ; Sildenafil Citrate

Sildenafil citrate, a cyclic monophosphosphate-specific type 5 phosphodiesterae inhibitor (PDE-I) widely used as first-line therapy for erectile dysfunction (ED). Since the approval of sildenafil in 1998, more than 40 million men worldwide have been successfully treated with PDE-I. As a result of this huge success, marketing strategies for PDE-Is have extended to include younger men, in particular who suffer from poor endometrial development and erectile dysfunction related to medical conditions such as diabetes and spinal cord injuries. The aim of this review is to investigate the effects of sildenafil citrate on endometrial thickness and seminal parameters in young, infertile patients.
Citric Acid ; Erectile Dysfunction ; Fertility ; Humans ; Infertility ; Male ; Marketing ; Piperazines ; Purines ; Spinal Cord Injuries ; Sulfones ; Sildenafil Citrate

Sildenafil citrate, a cyclic monophosphosphate-specific type 5 phosphodiesterae inhibitor (PDE-I) widely used as first-line therapy for erectile dysfunction (ED). Since the approval of sildenafil in 1998, more than 40 million men worldwide have been successfully treated with PDE-I. As a result of this huge success, marketing strategies for PDE-Is have extended to include younger men, in particular who suffer from poor endometrial development and erectile dysfunction related to medical conditions such as diabetes and spinal cord injuries. The aim of this review is to investigate the effects of sildenafil citrate on endometrial thickness and seminal parameters in young, infertile patients.
Citric Acid ; Erectile Dysfunction ; Fertility ; Humans ; Infertility ; Male ; Marketing ; Piperazines ; Purines ; Spinal Cord Injuries ; Sulfones ; Sildenafil Citrate

OBJECTIVETo investigate the ultrasonographic indexes in the evaluation of complete penile erection after oral administration of sildenafil citrate in men with normal erectile function.

METHODSThe subjects lay supine, with the penis raised upwards, its back clinging to the abdomen. The probe was placed at the base of the ventral side of the penis for longitudinal and transverse section scanning. Observations were made on the corpus cavernosum, deep artery and deep dorsal vein of the penis at the time of flaccidity and complete erection after oral administration of sildenafil citrate, respectively.

RESULTSThe examinations were acceptable to all the subjects both physically and psychologically, and all were completed successfully with no complications. Compared with the flaccid state of the penis, obvious changes were observed in the state of complete erection, including marked increases in the diameter of the corpus cavernosum ([18.57 +/- 2.50] mm, increased by [106.8 +/- 62.1]%), the inside diameter of the deep artery ([1.18 +/- 0.26] mm, increased by [54.9 +/- 29.0]%), the peak systolic velocity ([32.5 +/- 10.7] cm/s, increased by [209.3 +/- 112.9]%), and the systolic acceleration ([5.71 +/- 2.71] cm/s2, increased by [179.3 +/- 138.2]%).

CONCLUSIONOral administration of sildenafil citrate followed by ultrasonography is a new approach to the objective evaluation of penile erection, characterized by convenience, safety, non-invasiveness, non-complication, easy acceptability and easy clinical application.

Adult ; Humans ; Male ; Penile Erection ; drug effects ; physiology ; Penis ; diagnostic imaging ; Piperazines ; pharmacology ; Purines ; pharmacology ; Sildenafil Citrate ; Sulfones ; pharmacology ; Ultrasonography